Tenofovir alafenamide versus entecavir in treating patients with chronic hepatitis B: A meta-analysis.

Background: The superiority between TAF and ETV remains unclear. Which is the best choice for patients with CHB? Thus, this meta-analysis aimed to evaluate the efficacy and safety of TAF and ETV for patients with CHB.

Methods: MEDLINE/PubMed, Cochrane Library, EMBASE, Web of Science and CNKI were searched for eligible studies from inception to January 2024 and a meta-analysis was done.

Results: 24 trials with a total of 6753 subjects were screened. TAF significantly improved 12- and 24-week complete virological response (CVR), 12-week biochemical response (BR) and 24-week HBeAg loss, but could not improve 48- and 96-week CVR, 24-, 48- and 96-week BR, 96-week HBeAg loss, adverse events, 48-week HBsAg decline and loss, 12-, 24- and 48-week HBeAg seroconversion, 96-week HCC incidence compared to ETV. Subgroup analysis was conducted according to race, research type and switching. Different results were obtained from different subgroups.

Conclusions: TAF was superior to ETV at 12- and 24-week CVR, 12-week BR and 24-week HBeAg loss. Race and switching might affect the efficacy of TAF and ETV.